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Cocaine blocks the reuptake of dopamine and, to a lesser extent, norepinephrine and serotonin in the brain. This causes the accumulation of dopamine, leading to euphoria and excitation. The increased stimulation of dopaminergic neurons in the mesolimbic (reward) circuit leads to addiction.

Alcohol binds with GABA receptors producing inhibitory effects on neural activity. This produces cognitive impairment and reduced anxiety (disinhibition). Activation of GABA receptors also produces postsynaptic dopamine release, which stimulates the mesolimbic circuit in the brain, producing euphoria and addiction.

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